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I have quite a few patients that come in complaining of ‘depression.’ What originally was a specific condition has, like sciatica, fibromyalgia, and plantar fascitis become a catch all phrase for several different Patterns.

As a reminder: a pattern is the tree, whereas symptoms and diseases are the leaves and syndromes are branches… a pattern is a collection of all these things into one multi-faceted structure that describes a person’s personality, feelings, and illnesses.


The most common form of “mild depression” really isn’t depression at all. It’s a lack of free-flowing Liver Qi. Imagine a hose with air in it.The Liver in Chinese Medicine includes:
  1. liver organ
  2. sympathetic nervous system
  3. diaphragm response
  4. portions of the hearing and vision center
    1. This is via the lower CNS which controls many senses.
So when a person has either an excess of emotions or of substances ingested for the liver to transmute/metabolize it will stagnate the Liver Qi.

In order of worsening states:

  1. Pensiveness/consciousness stagnated
  2. Unexpressed emotions in the muscles
  3. Diaphragm Lock
  4. Organ stasis
  5. Organ Wind – upward or attacking other organs; tremors, dizziness, vertex headache with trembly and dark tongue
  6. Organ Fire – flank/scapula pain and burning urine or bowels, red eyes
  7. Organ Phlegm (fatty liver) – very thick coat especially one sides of tongue, bad breath, and red edges
  8. Organ Phlegm-Fire; nausea, vomit, crimson red tongue with thick coat, cataracts or glaucoma, sharp abdominal pains
  9. Phlegm carried by Wind to block sense organs; especially hearing and vision, but possibly taste or just thinking/clarity
  10. Phlegm ‘misting’ the Mind
    1. Psychiatric Disorders
    2. Personality Disorders
    3. Extreme Alcoholism/Addiction cases
Oppression can vary, and relative to each person, it is bearable to which degree that a) they are able to self-regulate using diet, exercise, and lifestyle habits and b) their “Element.”
Oppression differs from Depression by the excess presence of signs on the Tongue and in the pulse.
Tongue body will be darker, possibly from grey or blue all the way to black or portions black. It can be quivery or even deviated. It can be swollen or it can be lopsided, wide, square, or hilly.
The pulse will tend to go from wiry to tight to taught to thready to short to almost not present.
It may also contain electrical pulses, beans/hills, or even rock like edges. It is probably going to be hasty or rapid.All of this is the oppression of Qi tightening muscles in the muscular and smooth muscle.

The following are co-symptoms that may be present as well:

  • Low back pains
  • one-sided injuries and/or weakness
  • Blood sugar issues
  • Heart issues
  • Stomach pains/GERD
  • IBS/Chron’s/Collitis
  • Allergies & Asthma
  • Skin issues, especially dry
  • Age spots < age 70
  • Brittle hair and nails
  • Hard IT bands
  • Fascitis or growths in feet
  • Gout or GB stones
  • Prostatitis
  • Osteoarthritis or stenosis
  • Tinnitus or Meniere’s Disease
  • Migraines or Cluster Headaches
The solutions to these involve reversing the later stages backwards to stage 1, then maintaining regulating Liver’s Qi. The ‘depressed’ feelings will disappear with moving Qi; and thus a cure is affected although the pattern may likely remain.

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Deficiency of Qi, usually related to muscle loss, hypoglycemia, overwork and stress, and autoimmune wasting (even atrophy syndrome “wei”) will naturally lead to difficulty in moving Qi.
This is like having a river that has not enough water to move… it will form stagnant meres.
Sometimes this will lead to many of the same states as in the left column; only complicated because the deficiency is the main cause.
When there is a deficiency of Qi, there is very likely to be problems with the immune system.
  • Infections
  • Allergies
  • Joint pain
  • Headaches
  • Constipation
  • or loose bowels
  • Urinary incontinence
  • Lack of “get up and go”
  • Inability to make decisions
  • Weak Memory
  • Fatigue & Lethargy
  • possibly chronic
  • Inability to build muscle and lose fat
  • Rashes or other lesions
  • Increased back, knee, or hip stiffness.
Deficiency can of course lead to the very horrible Deficiency Syndrome which anyone with it can attest to this, is very hard to get proper treatment from mainstream or even alternative care. It takes so long to treat, has sooo many issues to work with, sometimes the people lose hope, give up, or just decide the finances cannot afford it.
As for dealing with the feelings of Depression surrounding deficiencies, it will be important to not overdo anything.
Yang Shen or Nourishing Life is the most important thing, and is a matter of dietary and lifestyle modifications.
To be honest, the most common thing I see is people work too hard and ignore the signs and continue working even when sick.
Deficiency of Qi has definite signs in the tongue:
Tongue: pale, scalloped, thin, quivery but not deviated, red tipped possible, thick coating possible, deep cracks or lots of small cracks possible, especially down the center.
The pulse will most likely be deep, slow, but possibly expiratory which appears as hasty or rapid, but different in its force.
If a patient takes their pulse and has difficulty finding it, this is probably a good indicator unless of course the flesh is too tight to allow one to find a pulse (this is taught, and see Oppression).
In dealing with this, it pretty much is an herbal remedy with all other therapies being adjunctive and of course long term altering one’s points of views on common misunderstanding such as:
  • What’s a “good” diet… for everyone it’s different
  • What’s a “good” exercise routine… cardio isn’t for everyone
  • What’s “respecting the Qi mean when it comes to work and home habits?
  • etc…
The most important thing is to have patience to be able to effect a long term cure for these cases. If the patient can find the discipline and focus, the prognosis is very good; otherwise, it is almost a matter of just trying to not let it get worse.

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Dealing with Depression

There are many people that can be treated with diet, lifestyle alone.
But the largest percentage need to use herbalism. Whether one chooses St. John’s Wort or one uses a Chinese Formula that more specifically fits the pattern and person… either way this could take a bit of time to deal with.
Anxiety will also be a common issue that must be addressed… see the next article for this topic.

However, in a select subset of patients, there is a Clinical Depression that has two important components that require Western Care:

  1. Chemical Imbalance; esp. leading to psychosis, suicidal thoughts, obsessive compulsive or eating disorders, and phobias
  2. Severe psychiatric trauma requiring therapy/psychiatric care;
    1. Or Addiction recovery
The reason why I say that Western Care should be sought is that there are many established professionals that are trained specifically in these areas. Alternative practitioners are not trained quite to that level. Treating Shen Disorders can only go so far, many cases really need Therapy.
As for chemical imbalances, the reality is that the Blood Brain Barrier can effect the speed with which herbs work. ALSO because of the peeling the onion effect… it may be more efficacious (ie: rapid) to adjust the chemicals in the brain now, while slowly building endorphin release and chemical-Qi production in a natural way.
People should not try to suffer through their Depression obstinately. I understand though that oftentimes western care has been ‘careless’ or ‘in compassionate’ or requires ‘pill-popping.’
This is why we try to work with practitioners that are sensitive to such issues and are mature. We do want each patient to talk openly about their trust issues and their goals. But if we honestly feel meds or therapy are required, we will make the referral.
Yet, many times we can approach treating your depression with slow methodical methods.
~Shifu Ramon C.


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